[精品]甲状腺激素和抗甲状腺药Thyroid48.pptVIP

甲状腺激素和抗甲状腺药Thyroid hormones and antithyroid drugs Pharmacology department , School of basic medicine , Peking union medical college 叶菜英 Thyroid hormones and antithyroid drugs Summary Thyroid hormones Necessary to maintain normal metabolism , growth and development. Hypothyroidism Cause Cretinism if it happens in embryo or neonatal period. Cause myxedema if it happens in adults when the thyroid hormone could be used in replacement therapy. Hyperthyroidism A syndrom characterized by thyroid oversecretion and metabolic disorder caused by multiple reasons. It can be treated with radioactive iodine (131I) irradation , antithyroid drugs and operation. Thyroid hormones Include： Thyroxine,T4 Triiodothyreninum natricum，T3 Synthesized and secreted by thyroid Antithyroid drugs Four categories： 硫脲类（Thiourea） 碘和碘化物 （复方碘溶液,lugol’s solution） 放射性碘（131I） β受体阻断药（心得安等从略） 硫脲类（Thiourea） 硫氧嘧啶类（thiouracil）： 甲基硫氧嘧啶（methykthiouracil） 丙基硫氧嘧啶（propylthiouracil） 咪唑类（imidazoles） 他巴唑 （Tapazole，甲巯咪唑methimazole） 甲亢平（卡比马唑Carbimazole） Thyroidhormones Thyroid hormones are iodic amino acids Active components Thyroxine,T4 Triiodothyreninum natricum，T3 Chemical constitution Chemical constitution of thyriod hormones Thyroid hormones physiological disposition Absorbed rapidly when take orally , activity T3T4，maintaining time T4T3。T1/2 of T4 and T3 are 6－7 days and 1－2 days , respectively。 Deiodination in mitochondria of liver and kidney , eliminated by kidney affer conjugated with glucuronic acid and sulfuric acid. T3、T4 can also pass the placenta and enter milk. Figure：the amount of normal adults’ thyroid hormones produced and metabolized daily. Synthesis , storage and regulation of thyroid hormones Iodine uptake Iodine activation and tyrosine iodation Condensation and storage Disintegration and release Regulation Steps of thyroid hormones synthesis , release and regulation Iodine uptake：I－ in blood can be uptaken into cells by iodine pump in th